A new company called Boulder is launching a digital rehab program. Boulder uses both medication like buprenorphine and peer support to help people recover from opioid addiction. It has raised $10.5 million in venture funding, led by Tusk Venture Partners, and signed a deal with the insurer Premera. The payer plans to give its members in Alaska access to Boulder in April and eventually expand to all two million members across the Northwest. Premera will pay Boulder a monthly flat rate for each patient, so the company can tailor each treatment program to the individual and keep it going for as long as they need.
Telemedicine and online drug prescription represent an opportunity to reach people suffering from opioid addiction on their own schedule. Instead of traveling to a dedicated rehab center that may not be close to home, a patient can come to Boulder through a hospital. Once inside the hospital, a doctor hands their patient a tablet loaded with Boulder’s software, and the patient conducts their first session over video there.
Over video chat, a doctor will then determine whether the person is an appropriate candidate for treatment with Suboxone, a medication that combines both buprenorphine, an opioid pain reliever, and naloxone, which blocks opioid effects. If they are, the doctor calls in the prescription to a local pharmacy and then rush-ships patients a kit with Narcane, a nasal spray version of naloxone that can bring someone back from an overdose, spit tubes for tests, and educational pamphlets to the patient. In an initial pilot in Southern Oregon, 85% of 100 patients stuck with the treatment program for eight months; 0nly one person went to the hospital because of relapse in that time.
Once a physician determines a person’s Suboxone regimen, patients are expected to conduct spit tests to check that they are adhering to their medication and to see if they’re using other substances. While on video conference with their physician, a patient spits into a tube, which they then mail in. Alternatively, the patient records themselves doing the spit test and then mails in the sample. Unlike in other programs, where a relapse might get a patient kicked out, at Boulder, if a person relapses, the doctor adjusts the treatment accordingly. The hope is that by taking a less punitive approach, patients won’t be inclined to send in fake results.
Though addiction treatment in general is not standardized, typical inpatient programs last 90 days or less, and outpatient programs can vary even more. Where a digital approach has the biggest potential is allowing physicians to create personalized programs in terms of the duration of peer support, dosage of medication, and how long a person stays on medication.
In addition to a doctor and medication, patients have access to a care advocate, who, much like a social worker, helps a patient with housing or finding a new job, and a peer coach, who offers emotional support as the patient works through sobriety. Unlike most treatment programs, this one has no end date. Patients can continue to be on Suboxone for as long as they feel necessary to mitigate their addiction.
Boulder does not have psychiatrists or therapists on its staff of care providers, but its insurance partner Premera plans to play a role in connecting patients to behavioral health near them. In addition to matching them to existing care providers, the company is hoping to fund new behavioral health facilities in rural communities through a series of grants worth a combined $15.7 million.
Why it’s Hot:
While the program is new and its efficacy remains to be seen, at a glance this looks like a really smart digital solution for a nationwide problem. For Premera, they stand to position themselves as a premier insurance provider for addiction treatment, which is a growing market. For Boulder, they could play a key role in shifting how we approach the opioid epidemic.
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